CN103169532B - Polyaxial bone anchoring device - Google Patents

Polyaxial bone anchoring device Download PDF

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Publication number
CN103169532B
CN103169532B CN201210553257.0A CN201210553257A CN103169532B CN 103169532 B CN103169532 B CN 103169532B CN 201210553257 A CN201210553257 A CN 201210553257A CN 103169532 B CN103169532 B CN 103169532B
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CN
China
Prior art keywords
head
bone anchoring
lug
polyaxial bone
pressure elements
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Active
Application number
CN201210553257.0A
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Chinese (zh)
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CN103169532A (en
Inventor
L·比德尔曼
W·马蒂斯
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Biedermann Technologies GmbH and Co KG
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Biedermann Technologies GmbH and Co KG
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Publication of CN103169532A publication Critical patent/CN103169532A/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7032Screws or hooks with U-shaped head or back through which longitudinal rods pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7001Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter

Abstract

A polyaxial bone anchoring device is provided including an anchoring element having a shank for anchoring in the bone and a head, the head having a spherical outer surface portion that includes a largest outer diameter; a receiving part having a top end and a bottom end, a channel for receiving a rod therein, a bore extending from the top end in the direction of the bottom end, the bore having a bore axis and a seat portion for receiving the head at the bottom end, wherein at least two circumferentially distinct recesses are provided in the seat portion; a pressure element arranged within the bore on top of the head, the pressure element having a head contacting surface portion that contacts the spherical outer surface portion of the head, wherein the head contacting surface portion includes at least two circumferentially distinct lugs that extend along a region of the head that includes the largest outer diameter in an axial direction; wherein the head is pivotable with respect to the receiving part and can be fixed at an angle by exerting pressure via the pressure element onto the head, and wherein the pressure element is configured to have an undersize with respect to the head only in a region of said lugs, such that when the pressure element is placed onto the head, the head is clamped by the friction between the spherical outer surface portion and the lugs and wherein the lugs are configured to extend at least partially into the recesses.

Description

Polyaxial bone anchoring device
Technical field
The present invention relates to a kind of Polyaxial bone anchoring device for being anchored at stabiliser bar in bone or in vertebra.The bone anchor Be fixedly mounted with put including anchoring element, the head for receiving the bone anchoring element and for receive be connected to it is described anchoring unit The receiving part of the stabiliser bar of part.The anchoring element is pivotably retained in the holder in the receiving part and can be with By pressure is applied to be fixed on certain angle on the head via the pressure elements being arranged in the receiving part. The anchoring element has head, and the head has the spherical outer surface part for including maximum outside diameter, and pressure unit Part includes head contact surface portion, and the head contact surface portion is included when the pressure elements is placed on the head Along the region of the maximum outside diameter including the head extend it is at least two circumferentially spaced(distinct)Lug.Institute State pressure elements and there is the undersize relative to the head in the region of the lug so that the head is by described Friction grip between head and the lug and before the head is finally locked so that the anchoring element is maintained at Desired Angle Position.
Background technology
US 2004/0267264A1 describe a kind of many shaft fixing devices, and wherein multiaxis bone screw includes joint element, institute Enough frictions that joint element is adapted to provide between spherical head and receiving element are stated so that spherical head is being locked in into reception Shank can be maintained at desired angular orientation before in element.Joint element is for example by the unlimited snap ring around head or by setting Frictionally engaging the spring element of spherical head or be realized by the slit that is located in compression cap at compression cap.
The content of the invention
It is an object of the invention to provide a kind of bone anchoring device, it allows perioperative improvement to operate, while ensureing peace Fix entirely, and it is simple to manufacture simultaneously.
The purpose is realized by anchor according to claim 1.Give in the dependent claims more Improve.
Using the bone anchoring device can realize head relative to receiving part in expect Angle Position slightly clamping and Not locking head.Receiving part is maintained at adjustable Angle Position by this permission.In this condition, pressure elements applies preload It is added on head, wherein head is not locked out, but prevents free pivot.When head is temporarily clamped, it is easy to receiving part The insertion of alignment and bar relative to bar, particularly in the case where multiple bone anchor assemblies are necessarily connected to bar.When bar is ready to When in insertion receiving part, the regulation of bar in the case where head is not exclusively unclamped remains possible.
The chi of pressure elements can be determined relative to head by the expectation frictional force between consideration pressure elements and head Amount that is very little and accurately limiting the preload being applied to by pressure elements on head in advance.
The bone anchoring device is simple to manufacture and in terms of head, receiving part and pressure elements tolerance relative to each other It is not strict.
Description of the drawings
The more features and advantage of the present invention will become obvious by means of accompanying drawing from the description of embodiment.
In the accompanying drawings:
Fig. 1 shows the perspective exploded view of the Polyaxial bone anchoring device according to first embodiment.
Fig. 2 shows the perspective view in the bone anchoring device of assembled state.
Fig. 3 shows the cross-sectional view in the Polyaxial bone anchoring device of assembled state, and the cross section is perpendicular to bar Obtain in the plane of axis.
Fig. 4 shows the top view of bone anchoring device.
Fig. 5 shows the cross-sectional view in the bone device of assembled state, and the cross section is obtained along the line A-A in Fig. 4 .
Fig. 6 shows the enlarged drawing of a part of Fig. 5.
Fig. 7 shows the perspective view of the receiving part of Polyaxial bone anchoring device.
Fig. 8 shows the side view of the receiving part of Fig. 7.
Fig. 9 shows the top view of receiving part.
Figure 10 shows the cross-sectional view of receiving part, and the section obtains along the line B-B in Fig. 9.
Figure 11 a)Show the side perspective of pressure elements.
Figure 11 b)Show Figure 11 a)Amplifier section.
Figure 12 shows the perspective view of pressure elements.
Figure 13 shows the top view of pressure elements.
Figure 14 shows the cross-sectional view of the pressure elements along the line C-C in Figure 13.
Figure 15 shows the amplification cross-sectional view of a part for bone anchoring device, and wherein pressure elements does not also apply pressure To on head.
Figure 16 shows the amplification cross-sectional view of a part for bone anchoring device, and wherein pressure elements pressure is applied to head In portion.
Specific embodiment
The Polyaxial bone anchoring device according to first embodiment for generally showing in fig 1 and 2 is included with threaded shanks 2 With the bone anchoring element 1 of the form in screw elements of head 3.Head 3 is configured to ball section, and the ball section has the equator for including ball Or the size of maximum gauge E.Have for the depression 4 with tool engagement in its free end head 3.The bone anchoring device is also Including for screw elements 1 to be connected to the receiving part 5 of bar 100.Pressure elements 6 is arranged in head 3 in receiving part On top.In order to by bar 100 be fixed in receiving part and in order to pressure is applied on head provide be in and receiving part 5 The outer locking member 8 for coordinating and the locking device 7 of the form of the interior locking member 9 coordinated with outer locking member 8.
Especially as shown in Fig. 3 to 10, receiving part 5 be substantial cylindrical and with top 5a, bottom 5b and from The lumen pore 51 that top 5a extends towards bottom 5b, the lumen pore has borehole axis C.In bottom 5b, there is provided receptacle part 52 with In receiving head 3.Receptacle part 52 is spherical, and the radius having corresponds roughly to the radius of head 3 so that head 3 is by receptacle portion Sub-support and head 3 is allowed to pivot in receptacle part 52 similar to ball-and-socket joint.Receptacle part 52 also connects with lumen pore 51 And with 52b is opened, the shank 2 of bone anchoring element may extend through the opening.Receptacle part 52 is in the mistake to lumen pore 51 The internal diameter crossed at portion more than head external diameter and less than lumen pore 51 internal diameter so that marginal portion 52a be formed at lumen pore 51 and hold Between seating portion 52.Adjacent top end 5a of female thread 54 is located at receiving part matches somebody with somebody for the outer locking member 8 with locking device 7 Close.
As shown in the illustrated embodiment, receiving part 5 is used as long head receiving part, leg and is included in extending Predetermined breakaway poing 5c at a certain distance from first end 5a, the predetermined breakaway poing allows fracture first end 5a and makes a reservation for disconnected Part between knick point 5c.Such long head receiving part for example can be used for Minimally Invasive Surgery.It should be noted that acceptance division Part 5 can also be designed without long head, and in this case first end 5a is approximately located at predetermined breakaway poing 5c.
In the lower part of receiving part, for example by cut off receiving part a part and formed inclined lower surface 5d with Anchoring element 1 is allowed to pivot with bigger angular side.Replace inclining lower end, receiving part can be designed to have permission and exist The symmetrical lower end of the symmetrical angulation on all directions.
In receptacle part 52, there is provided multiple circumferentially spaced depressions 55.Depression 55 is substantially ball section shape, the radius having It is significantly less than the radius of receptacle part 52.For example, as in the embodiment shown, four depressions 55 are formed in receptacle part, are being justified Look up in U-shaped depression both sides arrangement near two ends of U-shaped depression 53 and in the side of rod axis in circumferential direction.Depression 55 Partly expand the diameter of receptacle part and provide receiving space for the part for pressure elements described below.
Pressure elements 6 forms entirety.It is substantial cylindrical structure and with allow it in the axial direction receive The external diameter moved in the lumen pore 51 of part 5.Pressure elements 6 has top 6a and bottom 6b.On top, 6a is provided with generally U-shaped depression 61, the depression is configured to receive bar 100 wherein.The depth of depression 61 is caused when insertion rod more than the diameter of bar 100 By the free leg extension that formed of depression on the surface of bar 100.
In bottom 6b, there is provided for receiving the bulb-shaped recess 62 of head 3 wherein.The radius of bulb-shaped recess 62 is slightly larger than head The radius in portion 3 causes head 3 to be easily coupled in depression 62.In bottom, 6b has the four of roughly equidistant interval in a circumferential direction Individual breach, thus provides four lugs 63.Lug 63 has in side view(For example in Figure 11 a)In)The approximate V-arrangement seen, Wherein free end is flat or circle.However, the exterior contour of lug is not limited to the shape shown in embodiment.Example Such as, lug can be rectangle or U-shaped or shape in another manner.It is recessed that lug 63 is arranged into U-shaped near two ends of depression 61 61 left side and right side are fallen into, corresponding to the position of the depression 55 in receiving part 5.The length of lug 63 and the depth of bulb-shaped recess 62 Degree causes the lug 63 when pressure elements is installed on head 3 to extend beyond the region with maximum outside diameter E of spherical head 3. Referring in particular to Figure 11 b)Lug 63 is respectively provided with the first section 63a of neighbouring bulb-shaped recess 62 and extends to lug from the first section Free end the second section 63b.The internal diameter D of the first spherical segment 63a1Equal to or more than the ball of the head 3 being in contact with it The external diameter of shape outer surface part.The internal diameter D of the second spherical part 63b2The spherical surface portion maximum outside diameter E of head is slightly less than, For example it is approximately little 1% to 2% so that pressure elements 6 has the phase in the region of the second spherical part 63b of lug 63 For the slightly undersize of head.There is undersize before pressure elements 6 is placed on head 3.It can depend on real Border size and also depend on used material.When pressure elements 6 is placed on head 3, it is spherical that head 3 has to pass through second During part 63b is to move to bulb-shaped recess 62, the second spherical part 63b is thus slightly expanded.Therefore, pressure elements 6 is constructed Head is kept into the frictional force by being applied to by lug 63 on head.Can be by designing lug in a suitable manner(Particularly Second spherical part 63b)Size carry out the intensity of regulating friction force.
Additionally, pressure elements 6 has the coaxial lumen pore 64 for permission with the close screw head 3 of instrument.
It is body-compatible metal of all parts of bone anchoring device by body-compatible material manufacture, for example such as, for example all Such as Nitinol(Nitinol)Body-compatible alloy, or such as polyether-ether-ketone(PEEK)Body-compatible plastic material, or these The combination of material.The part can all by identical material or different materials.
Bone anchoring device is used under pre-assembled state.Under pre-assembled state, the head 3 of bone anchoring element 1 is maintained at Head is allowd in holder 52 in the interior pivot of holder 52 and shank extends through under shed 52b.Pressure elements is placed in head 3 On, as shown in figures 15 and 16.First, as shown in Figure 15, pressure elements 6 be aligned with receiving part 5 so that U-shaped depression 53 and 61 alignments.The circumferential location of depression 55 of the lug 63 in receptacle part 52.Pressure elements 6 is then towards receiving part Bottom 5b is shifted so that the second spherical part 63b of lug 63 is pressed in the spherical surface portion of the maximum gauge E including head 3 On.Thus, lug is extended slightly outwards until head 3 is coupled to the first spherical surface portion 63a of bulb-shaped recess 62 and lug In.Depression 55 provides space for the extension of lug 63.The wall of lug not engaging recess causes will not pressure elements jam to exist In receiving part 5.
As shown in Figure 16, head 3 contacts bulb-shaped recess 62 and lug 63 in certain contact area.Including head Lug is applied to preload on head so that head is clamped by the frictional force that lug 63 is applied in the region of maximum outside diameter E. Pressure elements can be by via the crimping shown in Fig. 3(crimp)Lumen pore 70 makes it crimp and tentatively be maintained at the position.
In use, at least two bone anchoring devices are anchored in bone parts or vertebra.Then receiving part is aligned to have Have for the correct orientation of insertion rod 100.Because head is temporarily clamped for pivoting receiving part, it is therefore necessary to such as handss Move ground applying power to overcome clamping force that there is correct orientation until each receiving part.When all receiving parts are aligned, insertion Connect the bar of bone anchoring device and tighten locking device 7.Using only pressure is applied on pressure elements 6 at the 6a of top Outer locking member 8, the Angle Position of head 3 is locked.Using the interior locking member 7 that only pressure is applied on bar 100, bar Fixed.
The modification of above-described embodiment is possible.For example, the quantity of lug and position can change.For by pressure elements Other means being tentatively fixed in receiving part are contemplated that.For example, crimping is replaced, receiving part can be by preventing pressure The effect of receiving part and the bonding part of pressure elements that element is departed from by the top 5a of receiving part 5 keeps.
For anchoring element, all types of anchoring elements can be used and combined with receiving part.These anchoring units Part is, for example, different length, the screw with different-diameter, hollow screw, the screw with different screw thread forms, nail etc..Head Can be attachable independent sector each other with shank.
Various types of receiving parts can be used, particularly with the receiving part of variable locking device.For example, replace Two-part locking device, it is possible to use while the integral locking device of securing rod and head, such as inner bolt.Additionally, outer spiral shell Female, outer cap, bayonet locking device etc. are also possible.Depression 55 can have another kind of shape, such as rectangle or U-shaped.
In another modification, receiving part is configured to allow for introducing screw elements from bottom.

Claims (14)

1. a kind of Polyaxial bone anchoring device, it includes:
Anchoring element (1), its there is head (3) and for being anchored at bone in shank (2), the head have include it is maximum directly The spherical outer surface part in footpath (E);
Receiving part (5), it has top (5a) and bottom (5b), the passage (12) for receiving bar wherein, at the bottom The lumen pore (51) extended from the top (5a) on the direction at end (5b), and for receiving the holder of the head in the bottom Partly (52), the lumen pore has borehole axis (C), wherein the receptacle part (52) are spherical;
Pressure elements (6), it is arranged on the top of the head in the lumen pore, and the pressure elements (6) is with contact The head contact surface portion (62,63) of the spherical outer surface part of the head (3), wherein the head contact surface Part includes at least two circumferentially spaced lugs (63), and the lug is along the head including the maximum gauge (E) Region extend in the axial direction;
Wherein described head (3) relative to the receiving part (5) pivotably and can be by via the pressure elements (6) Pressure is applied to be fixed on certain angle on the head, and
Wherein described pressure elements (6) is configured to before the pressure elements is placed on the head (3), only described There is the undersize relative to the head (3), the lug includes spherical segment (63b), institute in the region of lug (63) State the ball internal diameter (D that spherical segment has2) maximum gauge (E) of the head is less than, and it is spherical described in wherein at least Section (63b) extends on the region of the maximum gauge (E) with the head (3) so that when the pressure elements is put When on the head, the head by the friction grip between the spherical outer surface part and the lug, and wherein The lug is configured to extend at least partly in the receiving space (55) being located in the receiving part.
2. Polyaxial bone anchoring device according to claim 1, wherein the receiving space is by the receptacle part (52) Multiple depressions (55) formed.
3. Polyaxial bone anchoring device according to claim 1, wherein the lug (63) is respectively provided with the first spherical segment (63a) the second spherical segment (63b), is also respectively provided with, the ball internal diameter (D that first spherical segment has1) be equal or slightly larger than The maximum gauge (E) of the head, the ball internal diameter (D that second spherical segment has2) described less than the head Maximum gauge (E).
4. the Polyaxial bone anchoring device according to one of claims 1 to 3, wherein the pressure elements (6) is generally a cylindrical Shape, with upper end (6a) and lower end (6b), and wherein pressure elements has bulb-shaped recess in its lower end for facing the head (62)。
5. the Polyaxial bone anchoring device according to one of claims 1 to 3, wherein in addition to the lug (63), it is described The internal diameter that head contact surface portion (62) has is equal or slightly larger than the diameter of the head (3).
6. the Polyaxial bone anchoring device according to one of claims 1 to 3, wherein from the appearance of borehole axis measurement Receive space (55) depth more than the lug (63) outer radius.
7. the Polyaxial bone anchoring device according to one of claims 1 to 3, wherein when the pressure elements is placed in the head (3) when on, the lug (63) does not contact with the inwall of the receiving space (55).
8. the Polyaxial bone anchoring device according to one of claims 1 to 3, wherein provide from opposite side clamping the head At least two lugs (63).
9. Polyaxial bone anchoring device according to claim 2, wherein the depression (55) is with spherical.
10. Polyaxial bone anchoring device according to claim 2, wherein the quantity of the depression (55) corresponds to the lug (63) quantity.
11. Polyaxial bone anchoring devices according to one of claims 1 to 3, wherein the lug (63) is with towards freedom The generally V-shaped profile of end constriction.
12. Polyaxial bone anchoring devices according to claim 2, wherein the receiving part (5) is with bar receiving channel (53), and the pressure elements (6) is with bar receiving channel (61), and wherein when the bar receiving channel of the receiving part The lug (63) is arranged in the position of the depression (55) when being aligned with the bar receiving channel of the pressure elements.
13. Polyaxial bone anchoring devices according to one of claims 1 to 3, wherein providing locking device (7), the locking Device cooperates that the head (3) is locked in the holder (52) and by the bar (100) with the receiving part (5) In being fixed on the passage (12).
14. Polyaxial bone anchoring devices according to claim 8, wherein, the multiple lugs for being provided are in a circumferential direction etc. Away from interval.
CN201210553257.0A 2011-12-23 2012-12-19 Polyaxial bone anchoring device Active CN103169532B (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201161580012P 2011-12-23 2011-12-23
EP11195714.8 2011-12-23
US61/580,012 2011-12-23
EP11195714.8A EP2606841B1 (en) 2011-12-23 2011-12-23 Polyaxial bone anchoring device

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CN103169532A CN103169532A (en) 2013-06-26
CN103169532B true CN103169532B (en) 2017-04-12

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US (2) US9445847B2 (en)
EP (1) EP2606841B1 (en)
JP (1) JP6076069B2 (en)
KR (1) KR20130073848A (en)
CN (1) CN103169532B (en)
ES (1) ES2570782T3 (en)

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